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Biomedical subjects

V N Shelkovskiĭ

Publications and source records attributed to V N Shelkovskiĭ.

At least 19 recordsLinked to original sources
PubMed1987

[Odontogenic septic endocarditis].

In the operative treatment of 34 patients with septic endocarditis the identic microflora was isolated from odontogenous and cardiogenic foci of infection in 35% of the patients. Surgical sanitation of foci of odontogenous infection immediately before operation on the heart contributed to prophylactics of postoperative complications and recurrences of the main disease.

Adult↗
PubMed1986

[Prediction of recurrent hemorrhages from ruptured arterial aneurysms in the acute period].

In a series of 61 patients the authors studied the effect of some risk factors on the development of recurrences of haemorrhage from arterial aneurysms of cerebral vessels in the acute period of their rupture. The highest risk of recurrences was associated with an elevated fibrinolytic activity of the cerebrospinal fluid, spasm of the cerebral vessels, aneurysms of the anterior connective and internal carotid arteries as well as the patients' grave condition. Consideration of these factors makes it possible to specify the indications for surgical or conservative treatment. Antifibrinolytic therapy conducted in 5 patients with elevated fibrinolytic activity of the spinal fluid elicited good response.

Adult↗
PubMed1985

[Diagnosis and treatment of patients in the acute period of a subarachnoid hemorrhage as a result of rupture of arterial aneurysms of the brain].

The authors suggest a complex of measures for examination of patients with subarachnoidal hemorrhage (SAH), which makes it possible to elucidate the genesis of the hemorrhage and to decide on the tactics of treatment within the first hours after the stroke. They prove the necessity of hospitalization or transfer of patients with SAH to neurosurgical departments as well as of surgery in the acute stage of aneurysmal rupture.

Adolescent↗
PubMed1984

[Hyperbaric oxygenation in the prevention of mental disorders in patients during the acute period of severe craniocerebral injuries].

On the basis of a comparative analysis of the incidence of psychic disturbances seen in two groups of patients with craniocerebral trauma (subjects receiving HBO treatment and those without it), it is concluded that HBO is effective in preventing trauma-associated psychoses. The effect of HBO on the external respiration and central hemodynamics was also examined. The obtained results formed the basis for discussing possible pathogenetic mechanisms of hyperbaric oxygen action in this pathology.

Affective Symptoms↗
PubMed1984

[Hyperbaric oxygenation and prevention of recurrent cerebral circulatory disorders in the acute stage of a stroke].

The course of the acute period of cerebral stroke was compared in two groups of patients matched by the major clinical criteria: the test group receiving hyperbaric oxygenation (HBO) and the control one given no such treatment. It was found that the patients of the test group developed no recurrent impairments of the cerebral circulation in the acute period whereas in the control group this complication occurred in ten patients. Possible mechanisms of action of hyperbaric oxygen in preventing recurrent cerebral strokes are discussed.

Acute Disease↗
PubMedDate not supplied

[Surgical treatment of cerebral aneurysms complicated by vasospasm in the acute period].

The results of clipping of an aneurysm in the acute period of subarachnoid hemorrhage are analysed. It is shown that vascular spasm is an increased risk factor if it involves up to 3-4 and more arterial basal segments and is attended by marked general cerebral and focal neurological symptomatology and gross disorders of cerebral function. Such vascular spasm is unfavourable from the standpoint of prognosis in determining the outcomes of the operation.

Acute Disease↗
PubMedDate not supplied

[Effect of temporary interruption of blood flow through the major intracranial vessels on the outcome of surgical treatment of arterial aneurysms].

During operations for clipping an aneurysm, the blood flow along the artery supplying this aneurysm was temporarily arrested in some patients to prevent intraoperative hemorrhage. It has been proved that the arrest of blood flow along the main vessel for more than 20 minutes during an operation in the acute period of subarachnoidal hemorrhage, particularly in the presence of a vascular spasm, aggravates the course of the postoperative period and is conducive to the lethal outcome.

Acute Disease↗
PubMedDate not supplied

[Results of surgical treatment of intracranial arterial aneurysms].

The results of surgery for arterial aneurysms of the brain are analysed. It was found that the severity of the patient's condition rather than the time of the operation had an effect on the outcome of surgery. The severity of the patient's condition and the outcome of the operation were determined first of all by the presence of the intracranial hematoma, cerebrovascular spasm, escape of blood into the ventricles of the brain, and the degree of manifestation of subarachnoid hemorrhage. The advantage of early operations for the prevention of repeated ruptures of the aneurysm is pointed out.

Adolescent↗
PubMedDate not supplied

[Analysis of causes of death in the acute period of ruptured intracranial aneurysms].

The causes of death of 80 patients with ruptured aneurysms of the brain are analysed; 37 of them underwent operation. Intracranial hypertension with edema and dislocation of the brain was the main cause of death both of patients who were operated on and of those not subjected to surgery. Intensive subarachnoid hemorrhage, vascular spasm, intracranial hematoma, and the escape of blood into the ventricles of the brain lead to the development of intracranial hematoma. Besides, in patients who were operated on, edema of the brain developed as a consequence of its injury during manipulations and clipping of a large vessel. In some cases, death of patients with ruptured intracranial aneurysms was due to extracranial factors.

Adolescent↗
PubMedDate not supplied

[Fibrinolytic activity of cerebrospinal fluid as an indicator of the risk of repeated ruptures of arterial aneurysms].

The fibrinolytic activity of the cerebrospinal fluid and common venous blood flow was studied in 28 patients with ruptured aneurysms of cerebral arteries. Recurrent hemorrhage from the aneurysm was encountered in 8 of 11 patients with increased fibrinolytic activity of the cerebrospinal fluid but in none of the patients with absence of fibrinolysis in the cerebrospinal fluid. At the same time, intensified fibrinolytic activity was found in the common venous blood flow. It is suggested that the lysis of the clot at the site of the rupture of the aneurysmal sac is due to local fibrinolysis in the cerebrospinal fluid. Arterial spasm was detected in most patients with increased fibrinolysis in the fluid, and the severity of the general condition was graded III-V after Hunt and Hess.

Adult↗
PubMedDate not supplied

[Repeated intracranial hemorrhages, their prevention and treatment].

The formation of recurrent hematomas was encountered in patients operated on for intracranial hematomas of traumatic and nontraumatic origin and for contusion of the brain. To prevent recurrent hemorrhages, the authors employed active aspiration of the wound canal contents by means of a three-jar aspirator or a microaspirator in the postoperatice period in 56 cases. It is noted that active aspiration of the wound discharge, continued for 2--4 days, makes it possible to avoid the formation of recurrent intracranial hematoma and to reduce resorption of the decomposition products, this improves the course of the postoperative period.

Adult↗
PubMedDate not supplied

[Surgical strategy in the treatment of cranio-cerebral injuries associated with fractures of tubular bones].

The work is based on the analysis of 450 patients with combined injury; 272 of them underwent osteosynthesis in different periods after the injury. Examination and treatment of the combined injuries must be conducted simultaneously. Operations on the extremities are performed only after the patient recovers from shock. Indications and contraindications for applying instrumental methods of examination are discussed. The volume of the neurosurgical intervention in patients with combined craniocerebral injury comprises removal of the hematoma, correction and prevention of dislocation and secondary compression of the brain stem in the postoperative period, and hemostasis. Preference is given to resection trephination and to encephalotomy for removing an intracerebral hematoma. Secondary stem disorders are managed by tentoriotomy; ventricular drainage is applied in hydrocephalus. A classification is suggested which takes into account the severity of the craniocerebral injury and the severity of the injury to the extremity.

Brain Injuries↗